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FROM ERAS Envi----m -t-j, I— (THU?MAY 12 2017 15:.�"/ST. Y6:69/No.7500000470 P 7 .i <br /> DATE RECEIVED EHD LOG NUMBER <br /> ���� SAN JOAQUIN COUNTY <br /> RECE ENVIRONMENTAL WEALTH DEPARTMENT <br /> 600 East Mani St. Stockton, CA 95202-3029 <br /> SAY ,� J11ophone:-(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.orglehd <br /> PUBLIC RECORDS RELEASE APPLICATION ; <br /> NMENT <br /> A S V BUSINESSIAGENCY: If A <br /> ADDRESS: CITY/STATEIZIP:� �lCS <br /> PHONE(1): 6 0-A14 7•IMS-A&UPHONE(2):19S-3W--dgZ,(Z FACSIMILE:, _'tO"Cd(-S"31'� <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from data of application submittal-*Tentative only•must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$1 E(C H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _-_ —'J DATE <br /> Electronic Information: ❑List❑ map—Description: j <br /> FILE ADDRESS EHD USE ONLY i <br /> Street# Street Name City ❑Unit 1 J <br /> 0. � <br /> 2. 14 7(4 !!t%"V_. r r� ❑Unit 2 f/ <br /> 3. a <br /> 4. oeeU.it 3 <br /> 5. <br /> 6. <br /> Znitl <br /> 7. <br /> $• ❑U nit s <br /> 9. <br /> 10. ❑unit 0 <br /> Specific Date Range of information Requested: From All to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY [:1WASTE TIRE <br /> NDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL E3DAIRY <br /> AZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELMOTEL ❑PUMPER TRUCKIYARDICHEmtcAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: :MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Eax to 209 464-0138 or mail to the address Indicated Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be'processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for rerilew will be confirmed approximately ten(10) f <br /> days after receipt of application..The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any file not returned in the some condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review. <br /> EHD USE ONLY <br /> 4 <br /> I <br /> EHD 4"S 07@9!70 <br /> I <br /> I <br />